| In her eighth month of pregnancy a woman was stabbed in the abdomen with a barbecue fork. Upon delivery one week later, the child was noted to have two scars in the thoracic region on the back. The legs were flaccid. Surgical exploration at the age of seven months revealed marked, dense scarring of spinal cord and arachnoid membrane. No similar case was found in the literature. ( info) |
2/512. Pericardial drainage prior to operation contributes to surgical repair of traumatic cardiac injury. We report on two cases of successful surgical repair of cardiac injury: one involving a left ventricular stab injury and the other a blunt rupture of the right atrium. Each patient underwent emergency surgical repair, the former via left anterolateral thoracotomy and the latter via median sternotomy, following pericardial drainage tube insertion from the subxiphoid area. The operative approach was chosen according to the color of drained blood, i.e., arterial bleeding indicated left anterolateral thoracotomy, while venous bleeding indicated median sternotomy. We conclude that pericardial drainage via the subxiphoid approach prior to induction of anesthesia is an easy and useful technique to perform, not only to release cardiac tamponade but to determine the operative approach in patients suffering from cardiac tamponade following cardiac injury. ( info) |
3/512. Mesenteric thrombosis after penetrating cardiac trauma. survival of the severely injured trauma victim through aggressive therapy results in new complications. We report the first instance of mesenteric thrombosis in association with penetrating cardiac trauma. Selective visceral angiography should be obtained early in a patient with persistent abdominal pain following a period of prolonged shock; such cases should have a more favorable prognosis if diagnosed early in view of the limited period of cardiac dysfunction and the younger age group. ( info) |
4/512. An isolated ventricular septal defect as a consequence of penetrating injury to the heart. The authors describe, in a case report, an isolated defect of the ventricular septum developing due to a stab injury to the heart not requiring an emergency surgical intervention. Two months after the injury, the authors performed primary surgical correction of the defect. ( info) |
5/512. On scene thoracotomy: a case report. We report a case of on scene resuscitative thoracotomy performed by an anaesthetist on a patient in cardiac arrest following a stab wound to the chest. The patient made a good recovery and was discharged from hospital within 2 weeks. The rationale for performing resuscitative thoracotomy and who should perform this procedure are discussed. ( info) |
6/512. Access to the traumatized vertebral artery: an unusual approach. Although injuries to the vertebral arteries are relatively uncommon, there are several different methods used to gain access to these vessels, and to control any bleeding arising from them. We describe a case of torrential oropharyngeal bleeding following a stab wound to the neck in which rapid access to the vertebral artery was gained using a paramedian mandibulotomy; this approach has not previously been documented. The other approaches are discussed. ( info) |
7/512. An unusual case of suicide by stabbing with a falling weighted dagger. An unusual suicide by self-stabbing is presented. A 42-year-old man committed suicide with a dagger weighted with 2.72 kg in total and allowed to fall freely. The blade of the dagger fell from a height of 10 cm above the chest, penetrated the second left intercostal skin and pierced the upper lobe of the left lung. However, the weapon did not penetrate the chest skin from a stationary position in our trial at the autopsy. This finding confirms the results of experiments with stab wound dynamics which demonstrated that the impact velocity of the weapon as well as the sharpness of the tip is important for skin penetration. ( info) |
8/512. Laparoscopic cholecystectomy in penetrating trauma. laparoscopy in trauma is useful in diagnosing but limited in treatment. We report the case of a patient with a stab wound in the right upper quadrant and gallbladder perforation who underwent diagnostic and laparoscopic treatment. The therapeutic opportunities in abdominal trauma are scant for laparoscopic surgery; the isolated gallbladder injury is one of them, it being possible to apply the usefulness of this less invasive technique in this case. ( info) |
9/512. Sharp-force trauma analysis and the forensic anthropologist: techniques advocated by William R. Maples, Ph.D. Forensic anthropological tenets supported by William R. Maples, Ph.D. provide the bases for a case study from the C.A. Pound Human Identification Laboratory. Using a multidisciplinary team that included police investigators, pathologists, odontologists, entomologists, and anthropologists, a biological profile and trauma analysis was constructed. Our analysis determined that the decedent was a middle-aged Hispanic male, approximately 5'6"-5'7" in stature, who had died a minimum of three months before the discovery of his remains. Gross and microscopic analysis revealed 11 areas of sharp trauma to the skull and cervical vertebrae. To aid with analysis of the trauma, nonhuman trauma exemplars were created using a Tiger rear flail mower of the make known to have been used at the scene where the remains were recovered. This use of nonhuman trauma exemplars proved to be essential in the effort to exclude the rear flail mower as the possible trauma agent. ( info) |
10/512. Fatal brain injury caused by the free-flying blade of a knife - case report and evaluation of the unusual weapon. A man suffered a fatal injury from a self-inflicted accident while handling a special type of knife. A spring in the shaft of the knife accelerated the blade, which perforated the orbital cavity and the frontal lobe at the right side. death was due to central disregulation. The initial velocity of the blade was measured to be 15 m/s. In a total of 20 experimental shots to a fresh pig cadaver, the blade always penetrated the skin and 5-10 cm of soft tissue as long as the distance did not exceed 1 m. Thin layers of bone were also perforated. The free flight of the blade did not remain stable if the distance was more than 1 m, which resulted in superficial wounds only. So this unusual construction resembling a knife can be considered an effective combat weapon for close range fighting instead of a tool. ( info) |